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We elected not to propose use of a historical lookback approach (under options 1 and 2) because ASP units are often missing, negative, or equal to zero for the most recent calendar quarter and/or over several quarters in a four-quarter lookback period, and so including additional quarters may not necessarily yield additional data that could be used to apportion inflation rebate amounts (and could complicate the calculation of an average by introducing a mix of missing units, negative units, or units equal to zero, and positive units within a single NDC)

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Compared to cyanocobalamin, it is characterised by a stronger binding to tissue and serum proteins, which means a delayed excretion with the urine and thus a longer availability for absorption into the tissue stores

Demonstrates anti-inflammatory and cytoprotective properties in preclinical settings [6]